0001179110-18-012802.txt : 20181113 0001179110-18-012802.hdr.sgml : 20181113 20181113184941 ACCESSION NUMBER: 0001179110-18-012802 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20181031 FILED AS OF DATE: 20181113 DATE AS OF CHANGE: 20181113 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Christensen McCord CENTRAL INDEX KEY: 0001710861 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38163 FILM NUMBER: 181179857 MAIL ADDRESS: STREET 1: 500 EAST SHORE DRIVE STREET 2: SUITE 120 CITY: EAGLE STATE: ID ZIP: 83616 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PetIQ, Inc. CENTRAL INDEX KEY: 0001668673 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-DRUGS PROPRIETARIES & DRUGGISTS' SUNDRIES [5122] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: PETIQ LLC STREET 2: 500 E. SHORE DRIVE SUITE 120 CITY: EAGLE STATE: ID ZIP: 83616 BUSINESS PHONE: 208-939-8900 MAIL ADDRESS: STREET 1: PETIQ LLC STREET 2: 500 E. SHORE DRIVE SUITE 120 CITY: EAGLE STATE: ID ZIP: 83616 4 1 edgar.xml FORM 4 - X0306 4 2018-10-31 0 0001668673 PetIQ, Inc. PETQ 0001710861 Christensen McCord 923 S. BRIDGEWAY PLACE EAGLE ID 83616 1 1 0 0 Chief Executive Officer Class A Common Stock 2018-10-31 4 C 0 20000 0 A 20000 I See Footnote (2) Class B Common Stock 2018-10-31 4 C 0 20000 0 D Class A Common Stock 20000 488055 I See Footnote (2) Represents the exchange of Class B Common Stock into Class A Common Stock held of record by the reporting person. The shares are held by Christensen Ventures, LLC ("Ventures"). Mr. Christensen is the manager of Ventures and exercises voting and investment control over all shares held by Ventures. Each share of Class B Common Stock may be exchanged for one share of Class A Common Stock at the option of the holder and has no expiration date. This Form 4 is being filed late due to inadvertent administrative error. /s/ Robert Mooney, Attorney in Fact 2018-11-13